Renal atrophy and acute contralateral obstructive uropathy secondary to 2,8-dihydroxyadenine nephropathy: A case report based discussion on diagnostic pitfalls, FTIR spectroscopy, and literature review.

APRT deficiency leads to 2,8-DHA nephropathy. It manifests as recurrent radiolucent calculi and progressive renal failure. These stones are misidentified as uric acid stones. We report a 30-year-old male with recurrent left-sided nephrolithiasis, resulting in a poorly functioning left kidney. He subsequently presented with acute obstructive uropathy in his hypertrophied right kidney. FTIR post-ureteroscopy identified the composition as 2,8-DHA. This case underscores the necessity of precise stone analysis in recurrent urolithiasis. Increased awareness and knowledge of the limitations of some methods of laboratory analysis for renal stones should help to identify this type of stone and prevent renal damage.